By Maureen Gilmer, IU Health senior writer, firstname.lastname@example.org
It should have been a normal Friday morning tennis practice for Drew Strasser and his Rochester (Ind.) Community High School teammates.
It was anything but.
The 6 a.m. practice was held indoors because the court lights wouldn’t turn on outside, a twist that would prove providential for then 17-year-old Drew and those who saved him in early August, two days into the school year.
At 6:15 a.m., Laneia Strasser’s cellphone rang. Groggy from sleep, she thought it was her alarm going off at first. By the time it registered that her phone was dinging, she had missed the call.
When she looked at her phone, she saw it was a call from Drew’s tennis coach, but when she hit the call-back button, it was the local police who answered.
They didn’t know much, just that Drew had collapsed at practice, he wasn’t breathing, and an ambulance was taking him to the hospital.
It might be a heart attack, someone said.
It was enough to make a mother’s heart stop.
“I was in so much shock I don’t remember exactly what they said.”
RACE TO THE HOSPITAL
As she and her husband, Andy, gathered their two daughters and piled into the car, the authorities called back to let them know their son was breathing, but instead of going to the local hospital, they were going to South Bend, about an hour north.
As they drove north, Strasser’s mind was racing. “What in the world is happening,” she thought. “He was completely healthy Thursday night, and now we’re getting a call saying he isn’t responsive and he isn’t breathing on his own? It came out of nowhere.”
“It” was sudden cardiac arrest, the abrupt loss of heart function, breathing and consciousness.
And unfortunately, that’s how sudden cardiac arrest usually hits – out of nowhere. Yet it is the leading cause of death in high school athletes.
Lucky for Drew, a quick-thinking teammate and his coach began CPR at the direction of 911 operators and grabbed a nearby automated external defibrillator to shock his heart. Had they been out on the tennis courts, no AED would have been immediately available.
That intervention quite simply saved his life, said Riley cardiologist and electrophysiologist Dr. Adam Kean.
“He would have died if that AED had not been there.”
Drew was transferred to Riley later that day, where he was on a ventilator, sedated and unable to speak. That weekend, he developed a serious lung infection that nearly killed him, his mom said.
But he steadily improved, and three weeks later, he was discharged after surgery to implant a device that will shock his heart back into rhythm if needed.
Why this happened to Drew, or any young, healthy person, remains a mystery. As an athlete, he went through the typical sports physical before the start of the school year. It did not raise any alarms, but neither did a series of rigorous tests later in the hospital point to a cause.
NO IDENTIFIABLE ABNORMALITY
Despite the progress made in identifying genetic and molecular causes for heart irregularities, “there are still individuals who will go into lethal rhythms that we don’t have an identifiable cause for,” Dr. Kean said.
After putting Drew through every test available, Dr. Kean and his team found no identifiable gene or abnormality on his EKG, his echocardiogram or his MRI, and no problems with his exercise workup or electrophysiology study, so they were left with a diagnosis of idiopathic ventricular fibrillation. Idiopathic refers to something whose cause is unknown.
“That’s incredibly mystifying, but to a certain extent it is incredibly humbling, meaning that we still have a lot to learn about the cardiac conduction system and how we can identify and provide therapies for it,” the physician said.
In Drew’s case, those therapies include beta blockers and the implantable cardiac defibrillator.
Those safeguards and conversations with Drew and his family persuaded Dr. Kean to give the OK for the high school senior to return to the tennis court for sectional competition.
RISKS AND BENEFITS
“Twenty-five years ago, if someone suffered cardiac arrest and survived, they would be pretty much sidelined for the rest of their life,” Dr. Kean said.
While certain professions might be off-limits to someone with an ICD, the cardiologist takes a broader view when he weighs what’s best for his patients. That started with conversations with the now 18-year-old Drew and his parents.
“The decision to allow Drew to continue to participate in athletics is really a personal one. We have to be honest with ourselves and with him about what the risks and benefits are.”
The medication and the ICD lower the chances that he will have a recurrence, Dr. Kean said.
“It isn’t a guarantee, but we believe it decreases his risk,” he said. “When we go through this thought process and risk value analysis, many of us in this day and age say we want you to be able to embrace life but in a safe way. That means, taking your medicine, following up with us, taking basic life support courses and having friends and family know how to resuscitate him if he needs it.”
A MOM’S GRATITUDE
Drew and his doubles partner, Jake, the friend he’s known since preschool, the friend who responded in the moment to save Drew’s life, well, they lost that sectional match, but they know they won something far greater.
“It’s kind of hard to talk about still,” Drew’s mom said as she struggled to control her emotions. “This definitely has strengthened their bond. The fact that Jake was level-headed enough – in a moment of stress like that you don’t know how you’re going to react – he did what he needed to do to save his friend’s life. The same with his coach.”
She is grateful that her son’s school was equipped with AEDs that day – something she looks for now, inside and outside the school. And she is grateful for her son’s care at Riley.
“They took the best care of him possible. For as stressful of a situation that it was, we were 100 percent at the most amazing place. It’s hard to comprehend because unless you’ve been in that situation you don’t understand it, and I don’t wish that on anybody, but I felt we were in the right place for sure.”
It was only possible because there was an AED in the school gym that day and people weren’t afraid to use it, something Dr. Kean has been advocating for in recent years through his relationship with Project ADAM, named for a Wisconsin high school basketball player who died after collapsing on the court in 1997.
The program is designed to improve cardiac arrest preparedness in schools and other places where young people gather. Riley has partnered with a handful of schools in the state to get them certified as Heart-Safe Schools.
More and more public places are equipped with AEDs, which is good, Dr. Kean said, but training is key.
“We want everyone to feel empowered to use one of these things in an emergency.”
And even though Drew’s school is not Heart-Safe certified through Project Adam yet, they did everything perfectly, Dr. Kean said, and he looks forward to working with them in the future.
“They are the poster child for how schools should handle a situation like this.”
Meanwhile, Drew has returned to school and is looking forward to golf season in the spring.
“He has a great attitude,” his mom said, describing her son as happy, free-spirited and mature. “I’m very glad this hasn’t changed that.”
Photos submitted and by Laura Ault Photography